Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. Most often the surgery can be done in a doctor’s office or hospital clinic using a local anesthetic (numbing medicine). For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.
This is similar to an excisional biopsy (described in How are basal and squamous cell skin cancers diagnosed?), but in this case the diagnosis is already known. For this procedure, the skin is first numbed with a local anesthetic. The tumor is then cut out with a surgical knife, along with some surrounding normal skin. The remaining skin is carefully stitched back together, which will leave a scar.
Curettage and electrodesiccation
In this treatment, the doctor removes the cancer by scraping it with a long, thin instrument with a sharp looped edge on one end (called a curette). The area is then treated with an electric needle (electrode) to destroy any remaining cancer cells. This process is often repeated once or twice during the same office visit. Curettage and electrodesiccation is a good treatment for superficial (confined to the top layer of skin) basal cell and squamous cell cancers. It will leave a scar.
Mohs surgery (microscopically controlled surgery)
Mohs surgery is sometimes used when there is a high risk the skin cancer will come back after treatment, when the extent of the skin cancer is not known, or when the goal is to save as much healthy skin as possible, such as with cancers near the eye or other critical areas such as the central face, ears or fingers.
The Mohs procedure is done by a surgeon with special training. First, the surgeon removes a very thin layer of the skin (including the tumor) and then checks the removed sample under a microscope. If cancer cells are seen, another layer is removed and examined. This is repeated until the skin samples are free of cancer cells. This is a slow process, often taking several hours, but it means that more normal skin near the tumor can be saved. This can help the area look better after surgery.
Mohs can often offer better outcomes than some other forms of surgery and other treatments. But it’s also usually more complex and time-consuming than other methods. In recent years, skin cancer experts have developed guidelines for when it’s best to use this technique based on the type and size of skin cancer, where it is on the body, and other important features.
Lymph node surgery
If lymph nodes near a squamous or basal cell skin cancer are enlarged, the doctor might biopsy them to check for cancer cells (see How are basal and squamous cell skin cancers diagnosed?).
Sometimes, many nodes might be removed in a more extensive operation called a lymph node dissection. The nodes are then looked at under a microscope for signs of cancer. This type of operation is more extensive than surgery on the skin and is usually done while you are under general anesthesia (in a deep sleep).
Lymphedema, a condition in which excess fluid collects in the legs or arms, is a possible long-term side effect of a lymph node dissection. If it’s severe enough, it can cause skin problems and an increased risk of infections in the limb. Elastic stockings and compression sleeves can be used to help people with this condition. For more information, see Understanding Lymphedema (For Cancers Other Than Breast Cancer).
Skin grafting and reconstructive surgery
Last Revised: 05/10/2016